Andrew's Boarding Care

Type of visit: Required - 1 Year

On 08/13/2025 at 8:50AM, Licensing Program Analyst (LPA) Gina Saucedo conducted an unannounced, Annual Inspection and met with Violeta Tafatac, Caregiver. The licensee Arceli Andrade arrive about an hour later. LPA asked for the census, staff and resident files. The licensee arrived about an hour later. The physical plant was toured inside and out at 9:55am. Living/Dining Room Area: LPA Saucedo observed the living room furniture to be clean and in good repair. The facility maintains a comfortable temperature between 75 and 77 degrees Fahrenheit with a large television. There is another refrigerator in the dining hall area. There is a fireplace that is covered. Bedrooms: There are seven (7) bedrooms. Six (6) are used for residents and one (1) for a staff. In the hallway, there is a pantry filled with extra linen. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the resident’s room. There are four (4) bedrooms that have a private bathroom. Bathrooms: There are five (5) bathrooms that were toured and checked to make sure bathrooms were clean and in good repair. The hot water temperatures were measured within regulations of 108 degrees. The showers have non-slip bathmats and grab bars. Medications were kept in a locked pantry at the entrance of the facility on your left-hand side. All medications were properly labeled and inaccessible to residents. The first aid kit and the files are kept also in this pantry. LIC 809C-continued Kitchen Area: LPA inspected the kitchen area. There is one (1) refrigerator which was clean and in good operation in this area. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinets. The knives/sharps are in the kitchen on your right-hand side, inaccessible to the residents. The telephone line is on the counter. There is one (1) fire extinguisher fully charged and dated July-2025. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no bodies of water on the premises. There is one gate that is unlocked leading to the outside area towards the street. The washer and dryer are located inside next to the kitchen area. The chemicals are in this area inaccessible to the residents. The carbon monoxide and the smoke detector were tested, and they were operable, interconnected. There is no garage but there is two locked doors and inaccessible to the residents. This area has extra wheelchairs, bedding for the residents. There is a signal system for the facility. At the time of the visit, there was two (2) staff providing services. Administration: The Liability Insurance was reviewed and will be renewed on 12/2025. There are several Covid 19 signs on the wall, hygiene sanitation signs, and the Ombudsman sign against the walls of the facility, YES, Emergency Disaster Plan, Theft and Loss Policy, Facility Sketch, and Personal Rights An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the Licensee/Administrator.the state’s words, verbatim · CDSS document, Aug 13, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the applicant representative/administrator, Araceli Andrade and staff, Violeta Tagactac. A Change in Ownership (CHOW) Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on February 23, 2024. A fire clearance was approved on August 14, 2024 for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. The applicant is also requesting a hospice waiver to retain two (2) residents. The smoke alarms and carbon monoxide detector are dual and inter-connected. There are two additional carbon monoxide detectors installed in the living room and in the hallway. The facility has one fire extinguisher stationed in the kitchen. The charge date is 05/10/24. A tour of the physical plant was initiated at approximately 10am, after the Component III power point presentation was held. The following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, toaster oven, stove/oven and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). Knives are kept locked in a kitchen drawer. BEDROOMS: There are a total of seven (7) bedrooms in the facility. Six (6) bedrooms are designated for resident use. One (1) bedroom designated for staff. All six bedrooms are private. The bedridden fire clearance is approved for one (1) resident at any time for either room #5 or #6 (per STD 850). The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has five (5) bathrooms. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured between 105-107 degrees. COMMON AREAS: These included the living room and dining room areas. The living room is furnished with a couch, recliners and television. The dining room is furnished with a dining room table to seat six (6). The fireplace in the dining room is properly screened. No key or fireplace tools present. Floors were mopped and clean. Hallways and passageways clear of obstruction. LAUNDRY ROOM: The laundry room is located adjacent to the kitchen. Cleaning supplies are kept in a locked cabinet. Emergency food supply are kept in another cabinet, separate from the cleaning supplies. MEDICATIONS: Medications and medication records are kept locked in a closet by the entrance. 1st aid kit and manual also maintained with medications in the same closet. STAFF/RESIDENT RECORDS: Staff and resident records are also maintained in the medication closet by the front entrance. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio area and sufficient yard space. No swimming pool or any bodies of water on the property. There is no garage, but there are two locked storage spaces located at the front. Old/previous facility records are kept locked in one storage space. Excess wheelchair, bed/furniture, kept locked in the other storage space. COMPONENT III: In addition to the Pre-Licensing inspection, a Component III power point presentation was held prior to the walk through. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, Sep 11, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 3 COMP II Participants: Name - Arceli Andrade CEO/Administrator Interview Method: Telephone interview On August 21, 2024, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-Licensing Readinessthe state’s words, verbatim · CDSS document, Aug 21, 2024